ABSTRACT
ObjectiveTo explore the effect of core muscles training based on spinal fine-tuning manipulation on lumbar facet joint disorders. MethodsFrom February, 2021 to February, 2022, 80 patients with lumbar facet joint disorders in Huadong Hospital Affiliated to Fudan University were randomly divided into control group (n = 40) and observation group (n = 40) randomly. Both groups received routine treatment and spinal fine-tuning manipulation, while the observation group received core muscles training in addition, for six weeks. They were assessed with Japanese Orthopaedic Association (JOA) scores, Short-Form of McGill Pain Questionnaire and World Health Organization Quality of Life-BREF before and after treatment. The recurrence rate was observed after three months follow-up. ResultsThe scores of all the scales improved after treatment (t > 5.751, P < 0.001), and improved more in the observation group than in the control group (t > 2.051, P < 0.05). After three months follow-up, the recurrence rate was 7.89% (3/38) in the observation group, less than 28.13% (9/32) in the control group (χ2 = 5.005, P = 0.025). ConclusionCombination of core muscles training may improve lumbar function, reduce lumbar pain, reduce recurrence and improve quality of life for patients with lumbar facet joint disorders.
ABSTRACT
BACKGROUND: Lumbar facet joint degeneration has become the focus of scholars’ research in recent years. Understanding the risk factors of lumbar facet joint degeneration plays a key role in preventing and reducing the damage to spine health. Moreover, comprehending its anatomy has important guiding significance for the treatment of spine-related diseases and related operations. OBJECTIVE: To briefly describe the anatomy and histological characteristics of the lumbar facet joints, and summarize the risk factors of lumbar facet joints degeneration. METHODS: A computer-based search of CNKI, Wanfang database, VIP database, PubMed, Elsevier and Web of Science was performed with the search terms “lumbar facet joint, joint capsule, articular direction, eneurosis, osteoarthritis, biomechanics, low back pain, intervertebral disc degeneration, lumbar spondylolisthesis, lumbar degenerative scoliosis” for articles published from March 2018 to September 2019. Review, basic research and clinical research were screened by reading title and abstract. The studies with low relevance to the subject were excluded, and 60 studies were included in the final analysis. RESULTS AND CONCLUSION: (1) The main risk factors for lumbar facet joint degeneration include age, gender, abnormal stress, articular surface orientation, joint asymmetry, lumbar segment and disc degeneration. (2) When the joints degenerate, it can cause low back pain, disc degeneration, lumbar spondylolisthesis, degenerative scoliosis and other clinical diseases, which seriously affect people’s daily life and work, and reduce people’s living quality. Therefore, lumbar facet joints should not be ignored in the treatment of spine-related diseases.
ABSTRACT
Objectives To investigate the relationship between the degeneration of lumbar multifidus mus-cles and facet joint osteoarthritis(FJOA)by MRI. Methods This retrospective study included 248 patients with low back and leg pain,aged from 55 to 70.MRI was used to measure TCSA,FCSA,fCSA and FI% of the L4~5and L5~S1segments on the both sides of their multifidus muscle in the cross section in T2weighted image.All the cases were divided into three grades:grade 0~1,grade 2 and grade 3 according to their FJOA grades. The relationship between the FJOA grades at the same level and TCSA,FCSA and FI% of both sides was analyzed retrospectively. Results There were significant differences of the FI% of the multifidus muscle between both sides of the two seg-ments(P < 0.05);The TCSA,FCSA and fCSA of the left and right multifidus muscle all showed an increasing trend from L4~5to L5~S1segment and the difference was statistically significant(P<0.05);the FI% of two sides of multifidus muscle was negatively correlated with the right FJOA grade at L5~S1segment(P<0.05).There was a re-lationship between females and right FJOA grade at L5~S1segment(all P < 0.05). Whereas,no significant differ-ence was found in other parameters(all P>0.05).Conclusions There is no relationship between the cross-sec-tional area of the multifidus muscle and the FJOA grade. The higher FI% degree of multifidus muscle in the L5~S1 segment is accompanied with a lower grade of FJOA.The degeneration of multifidus muscle occurs earlier than the degeneration of articular process joints,so the earlier exercise of lumbar muscle is recommended.
ABSTRACT
Objective To observe the effect of extracorporeal shock wave (ESW) combined with intervertebral foramen injection on the lumbar facet joint syndrome.Methods Ninety-three patients presenting the syndrome were randomly divided into acombined group,ashock wave group and acontrol group,each of 31,according to a random number tab.All three groups were given a nonsteroidal anti-inflammatory drug,the shock wave group was additionally treated with a course of ESW,while the combined group received the shock wave treatment and lumbar intervertebral foramen injection.The three groups were assessed using theOswestry disability index (ODI),theRoland Morris Disability Questionnaire (RMDQ)and a life quality scale (QOL-SF36) beforetreatment and after 1,4 and 8 weeks of treatment.Pain was reported using a visual analogue scale (VAS).Results Theaverage VAS,ODI,RMDQ and QOL-SF36 scores of the three groups had all improved after the treatment.After one week the average scores of VAS (2.6±1.4),ODI (15.9±8.3),RMDQ (9.9±5.4) and QOL-SF36 (74.6±17.1) of the combined group had improved significantly more than those of the control group [VAS (4.3± 1.3),ODI(22.8± 6.9),RMDQ (14.9±7.7) and QOL-SF36 (61.6±17.7)].Fourweeks after the treatment,the averageVAS,ODl,RMDQ andQOL-SF36 scores [(2.5±1.3),(15.1±7.3),(9.8±5.1) and (76.8±16.8)] of the shock wave group had improved significantly more than those of the control group [(3.9 ± 1.4),(20.3 ± 8.2),(13.9 ± 8.1) and (67.2±20.6)].Such significant improvements lasted until 8 weeks after the treatment.ConclusionsESW combined with intervertebral foramen injection can relieve the pain oflumbar facet joint syndrome,improve lumbar vertebral function and patients' quality of life.It is worthy of clinical application.
ABSTRACT
Objective To observe the clinical efficacy of acupuncture plus activator method chiropractic technique (AMCT) in treating lumbar facet joint disorders.Method A total of 40 patients with lumbar facet joint disorders were randomized into a treatment group and a control group, 20 cases in each group. The treatment group was intervened by acupuncture plus AMCT, while the control group was treated with AMCT alone. The Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) were observed in the two groups before and after 3 treatment sessions, and the clinical efficacies were compared between the two groups.Result The VAS score and JOA score were significantly changed right after the 1st treatment and after 3 treatment sessions in the two groups (P<0.05). Right after the 1st treatment and after 3 treatment sessions, there were statistically significant differences in the VAS score and JOA score between the two groups (P<0.05). The total effective rate was 90.0% in the treatment group versus 60.0% in the control group, and the difference was statistically significant (P<0.05). The relapse rate was 22.2% in the treatment group versus 50.0% in the control group 3 months after the treatment, and the difference was statistically significant (P<0.05).Conclusion Acupuncture plus AMCT is an effective approach in treating lumbar facet joint disorders.
ABSTRACT
Objective To assess the therapeutic effect of imaging-guided pulsed-radiofrequency stimulation of medial branch of lumbar spinal nerve in treating lumbar facet joint syndrome. Methods A total of 48 patients with clinically-diagnosed lumbar facet syndrome were randomly divided into group A (anti-inflammatory and analgesic group, n=26) and group B (pulsed-radiofrequency group, n=22). The patients of group A received oral meloxicam dispersible tablets , while the patients of group B were treated with DSA-guided pulsed-radiofrequency stimulation of dorsal medial branch of lumbar spinal nerve corresponding to the diseased lumbar facet. Using visual analogue scale (VSA) the severity of pain at the time of admission, discharge and 6 month after discharge was separately evaluated , and the therapeutic effect was assessed based on the improvement of VSA score. Results The VAS scores of group A and group B at the time of discharge and 6 months after discharge were significantly lower than those determined at the time of admission (P<0.01). At the time of discharge, the VSA score of group B was significantly lower than that of group A (P<0.05). Six months after discharge, the VAS score of group B was significantly lower than that of group A (P<0.05). The total effective rates at 6 months after di scharge of group A and group B were 46.5% and 87.6% respectively;the excellent effect rates of group A and group B were 26.4% and 76.2% respectively. Both the total effective rate and excellent effect rate of group B were significantly higher than those of group A (P<0.01). Conclusion Imaging-guided pulsed-radiofrequency stimulation of dorsal medial branch of lumbar spinal nerve can effectively relieve chronic lower back pain caused by lumbar facet joint syndrome , and its therapeutic effect is superior to oral anti-inflammatory and analgesic medication.
ABSTRACT
Acupuncture has become a popular alternative modality in the treatment of back pain. However, few have reported complications related to this treatment modality. This study reports a rare case of septic arthritis of the lumbar facet joints, developing after acupuncture, and its devastating effects upon the patient. A 68-year-old female developed septic arthritis of the lumbar facet joints after acupuncture for symptomatic control of lumbar spondylosis and stenosis while waiting for surgery. Subsequently, successful control of the infection required a total of 4 hospital admissions over a 2-year period, a CT guided spinal biopsy and 6 months of antibiotics.
ABSTRACT
BACKGROUND: Facet joint have been implicated as a source of chronic low back pain. Radiofrequency denervation has demonstrated the most solid evidence. To increase safety and efficacy of treatment, computed tomography (CT) guidance injection has been used in several disease. The purpose of this study was to evaluate the efficacy of CT-guided radiofrequency rhizotomy in the treatment of facet joint pain. METHODS: A total of 40 patients were randomized to undergo radiofrequency facet joint denervation under CT guidance or C-arm guidance. All patients were examined visual analogue scale (VAS) score before treatment, 1 month, and 3 months after treatment. RESULTS: The VAS in both groups showed significant improvement over the 1-month interval. No significant difference in the VAS score among the group was observed. CONCLUSIONS: In this study there was no significant difference between CT guidance lumbar rhizotomy and C-arm guidance lumbar rhizotomy. Therefore CT-guided radiofrequency denervation of the lumbar facet joint was a minimally invasive technique that appears effective.
Subject(s)
Humans , Denervation , Low Back Pain , Rhizotomy , Zygapophyseal JointABSTRACT
STUDY DESIGN: A prospective study. PURPOSE: To determine the success rate and duration of relief of radiofrequency neurotomy for lumbar facet joint pain. OVERVIEW OF LITERATURE: There is a lack of effective treatment for chronic low back pain. Radiofrequency denervation appears to be an emerging technology, with substantial variations in use. METHODS: Fifty-eight patients underwent radiofrequent neurotomy on the posterior primary ramus for chronic low back pain. All patients with low back pain of more than 3 months duration, with or without non-radicular radiation to the buttock and hip, were included in the study. From October 2005 to December 2006, eligible patients underwent a standardized diagnostic work-up, which included the use of a visual analog scale (VAS), physical examination, review of imaging studies, and diagnostic blockades. Pain relief was assessed on the third day, and at 3 months and 6 months post-treatment, using the visual analog scale. RESULTS: There were 44 women and 14 men included in the study. The mean age was 57.7 years (range, 20~80 years). Radiofrequency neurotomy denervated three segments and a bilateral lesion in all patients. The visual analogue scale (VAS) scores on the third day (mean VAS score: 1.48) and 3 months (mean VAS score: 1.79) after treatment decreased significantly when compared with the pre-treatment scores (mean VAS score: 6.56). However, the final values of the VAS scores after 6 months were slightly increased as compared to the VAS scores measured at the beginning of the study (mean VAS score: 2.91). No cases of infection, new motor deficits, or new sensory deficits were identified. CONCLUSIONS: We suggest that radiofrequency neurotomy offers an effective palliative management of lumbar facet pain. However, there is limited evidence that radiofrequency neurotomy offers short-term relief for chronic low back pain. Further high-quality randomized controlled trials are needed with larger patient numbers and more data on the long-term effects, for which current evidence is inconclusive.
Subject(s)
Female , Humans , Male , Buttocks , Denervation , Hip , Low Back Pain , Physical Examination , Prospective Studies , Visual Analog Scale , Zygapophyseal JointABSTRACT
Objective To observe the therapeutic effects and assess the feasibility of radiofrequency thermo- coagulation denervation(TRD)mediated by digital subtraction angiography(DSA)for patients with lumbar facet joint syndrome(LFJS).Methods Eighty LFJS patients were randomly divided into two groups:a denervated group(groupⅠ)and a control group (groupⅡ).The lumbar facet joints of the patients in groupⅠwere treated with TRD,while those in groupⅡhad their lumbar facet joint cavities injected with the mixture of 1 mg betamethasone and 1 ml lidocaine.All patients were assessed using the Visual Analog Scale(VAS)before treatment and 30 rain,1 d, 1 w,1 m and 6 m after.Schober values were measured at 1 w,1 m and 6 m after treatment.The therapeutic effects and side effects were assessed at 6 m after treatment.Results VAS scores in groupsⅠandⅡat 30 min,1 d,1 w and 1 m after treatment were remarkably lower than before treatment.In addition,those in groupⅠ6m after treatment were also significantly lower(P＜0.01).Compared with those in the groupⅡ,VAS scores in groupⅠwere signifi- cantly decreased at 1 m and 6 m after treatment(P＜0.05 and P＜0.01,respectively).The schober values in groupⅠat 1 m and 6m were obviously increased in comparison with those in groupⅡ,while the therapeutic effects in groupⅠat 6m after treatment were better than those in groupⅡ(P＜0.01).There were no side effects,such as injuries to the nerve roots or dysfunctional dermal sensation,in either group.Conclusion TRD,mediated by DSA,has ther- apeutic effects on LFJS.Such treatment is safe,convenient,and gives long-term pain relief.